Mark James Jones, OD
Individual provider Active NPI Optometrist · Swanton, OH
NPI 1780723593 · NPPES record last updated Jul 29, 2010
Key facts
- NPI
- 1780723593
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4203 T501 (OH)
- Practice address
- 107 E Airport Hwy
Swanton, OH 43558 - Phone
- (419) 826-3937
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101122000146 | OH | Practitioner - Optometry | 0648385088 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4203 | OH | MD | Chiropractor |
| 4203 T501 | OH | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4203 T501 | OH | Yes |
Addresses
Primary practice location
107 E Airport Hwy
Swanton, OH 43558
Mailing address
107 E Airport Hwy
Swanton, OH 43558
Phone (419) 826-3937
Other providers in Swanton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.